Acute Contaminant Breakthrough in Double-Pass Reverse Osmosis Water for Online Hemodiafiltration: A Monitoring Blind Spot, “The Samovar Makers’ Phenomenon”

Authors

  • Reza Hekmat Department of Nephrology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Academic degree: Associate Professor. Author

DOI:

https://doi.org/10.61882/ijkd.20.5.9635

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References

1. Association for the Advancement of Medical Instrumentation. Water Quality for Hemodialysis and

Related Therapies. ISO 13959:2020.

2. Ward RA. Environmental contaminants in hemodialysis: the subtle trap of sub-threshold bioaccumulation. J Nephrol. 2019;32(4):511-9.

3. D’Haese PC, De Broe ME. Trace elements and heavy metal toxicities in end-stage renal disease patients.

Kidney Int. 2021;99(3):562-75.

4. Flendrig JA, et al. Hard-water syndrome: severe calcium and magnesium toxicity during hemodialysis. Lancet. 1976;308(7981):350-3.

5. Brunet P, et al. Nitric oxide precursors and intradialytic hypotension: the role of dialysate nitrate contamination. Hemodial Int. 2001;5(2):89-94.

6. Alfrey AC, et al. Dialysis encephalopathy syndrome: possible aluminum and trace metal etiology. N Engl J

Med. 1976;294(4):184-8.

7. Indika SR, et al. Dialysate-induced methemoglobinemia and refractory anemia from agricultural nitrate runoff. Am J Kidney Dis. 2022;79(5):702-9.

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Published

2026-10-19

Data Availability Statement

Data are available 

 

How to Cite

Acute Contaminant Breakthrough in Double-Pass Reverse Osmosis Water for Online Hemodiafiltration: A Monitoring Blind Spot, “The Samovar Makers’ Phenomenon”. (2026). Iranian Journal of Kidney Diseases, 20(5), 342-343. https://doi.org/10.61882/ijkd.20.5.9635